Provider Demographics
NPI:1194815613
Name:GOLOMB, BEATRICE (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:BEATRICE
Middle Name:
Last Name:GOLOMB
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 GILMAN DR
Mailing Address - Street 2:DEPT OF MEDICINE, UCSD SCHOOL OF MEDICINE, 0995
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-5004
Mailing Address - Country:US
Mailing Address - Phone:858-558-4950
Mailing Address - Fax:858-558-4960
Practice Address - Street 1:3350 LA JOLLA VILLAGE DR
Practice Address - Street 2:VA SAN DIEGO HEALTHCARE CENTER MAILCODE 111N
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0002
Practice Address - Country:US
Practice Address - Phone:858-552-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG072640207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine